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Table 3 Parallel Testing Regime: Community Peer Organisation Bulk Billing GP Clinic Setting (Funded by Federal Government - Medicare and State Government)

From: Economic evaluation of alternative testing regimes and settings to detect undiagnosed HIV in Australia

 

True HIV Positive (PHIV)

True HIV Negative (1 − PHIV)

Outcomes

DHC+, EIA+, WB+

DHC-, EIA+, WB+

DHC+, EIA-

DHC-, EIA-

DHC+, EIA-

DHC+, EIA+, WB-

DHC-, EIA+,WB-

DHC-, EIA-

Probability of result

(PHIV ∗ SenDHC ∗ SenEIA ∗ SenWB)

(PHIV ∗ (1 − SenDHC) ∗ SenEIA ∗ SenWB )

(PHIV ∗ SenDHC ∗ (1 − SenEIA))

(PHIV∗

(1 − SenDHC) ∗ (1 − SenEIA))

((1 − PHIV) ∗ (1 − SpecDHC) ∗ SpecEIA)

((1 − PHIV) ∗ (1 − SpecDHC) ∗ (1 − SpecEIA) ∗ SpecWB )

((1 − PHIV) ∗ SpecDHC ∗ (1 − SpecEIA) ∗ SpecWB )

((1 − PHIV) ∗ SpecDHC ∗ SpecEIA )

Inputs

 Visit 1: Initial Screening

  Consult time

20 min

20 min

20 min

20 min

20 min

20 min

20 min

20 min

  Medicate Rebate

$71.701

$71.701

$71.701

$71.701

$71.701

$71.701

$71.701

$71.701

  Staffing

GP

GP

GP

GP

GP

GP

GP

GP

 Pathology costs

  Rapid Alere Determine Test (DHC)

$11

$11

$11

$11

$11

$11

$11

$11

  EIA

$15.652

$15.652

$15.652

$15.652

$15.652

$15.652

$15.652

$15.652

  WB confirmatory

$29.003

$29.003

   

$29.003

$29.003

 

 Visit 2: Test Results

  Consult time

40 min

40 min

20 min

 

20 min

20 min

20 min

 

  Medicare Rebate

$105.554

$105.554

$71.701

 

$71.701

$71.701

$71.701

 

  Staffing

GP

GP

GP

 

GP

GP

GP

 

Total Cost of Each Outcome

$232.90

$232.90

$170.05

$98.35

$170.05

$199.05

$199.05

$98.35

Average cost per person tested

=(PHIV ∗ SenDHC ∗ SenEIA ∗ SenWB) ∗ AC per True HIV PositiveDHC + , EIA + , WB+ + (PHIV ∗ (1 − SenDHC) ∗ SenEIA ∗ SenWB) ∗ AC per True HIV PositiveDHC − , EIA + , WB+ + (PHIV ∗ SenDHC ∗ (1 − SenEIA)) ∗ AC per False NegativeDHC + , EIA− + (PHIV ∗ (1 − SenDHC) ∗ (1 − SenEIA)) ∗ AC per False NegativeDHC − , EIA− + ((1 − PHIV) ∗ (1 − SpecDHC) ∗ SpecEIA) ∗ AC per False HIV PositiveDHC + , EIA− + ((1 − PHIV) ∗ (1 − SpecDHC) ∗ (1 − SpecEIA) ∗ SpecWB) ∗ AC per False HIV PositiveDHC + , EIA + , WB− + ((1 − PHIV) ∗ SpecDHC ∗ (1 − SpecEIA) ∗ SpecWB) ∗ AC per False HIV PositiveDHC − , EIA + , WB− + ((1 − PHIV) ∗ SpecDHC ∗ SpecEIA) ∗ AC per True NegativeDHC − , EIA−

Average number of tests for a positive diagnosis

\( =\frac{1}{\left({P}_{HIV}\ast Se{n}_{DHC}\ast Se{n}_{EIA}\ast Se{n}_{WB}\right)+\left({P}_{HIV}\ast \left(1- Se{n}_{DHC}\right)\ast Se{n}_{EIA}\ast Se{n}_{WB}\right)} \)

  1. Note: AC Average Cost, DHC Alere Determine™ HIV-1/2 Ag/Ab Combo Test, EIA fourth generation enzyme immunoassay test, GP General Practitioner, P Probability, Sen Sensitivity, Spec Specificity, WB Western Blot Test, + reactive test result, − nonreactive test result. 1 = Medicare Rebate Item 36; 2 = Medicare Rebate Item 69,384; 3 = Medicare Rebate Item 69,387; 4 = Medicare Rebate Item 44